The big sleep: Melatonin could lead to higher risk of heart failure
If you’re one of the 67 million Americans who regularly use melatonin to combat insomnia, you might end up falling into a much deeper sleep than you bargained for. That’s according to a new study, which drew associations between long-term, habitual melatonin use and a higher risk of heart failure over a five-year period.
A team of researchers led by Dr. Ekenedilichukwu Nnadi at SUNY Downstate/Kings County Primary Care in New York examined medical records for more than 130,000 adults with insomnia. The participants were then split into two groups –– those who regularly took melatonin for a year or more, and those who didn’t.
The records were pulled from the TriNetX Global Research Network, an international database of de-identified medical records.
Melatonin and heart failure
The researchers found that those who reported taking melatonin for a year or more had roughly a 90% higher chance of heart failure over five years when compared with participants who suffered from insomnia, but didn’t use melatonin to treat it.
Similarly, the melatonin group was 3 1/2 times more likely than the non-melatonin group to be hospitalized for heart failure, and almost twice as likely to die from any cause over the five-year period examined in the records.
“Melatonin supplements may not be as harmless as commonly assumed,” Nnadi said in a press release. “If our study is confirmed, this could affect how doctors counsel patients about sleep aids.”
Of the 130,828 people analyzed by Nnadi’s team, 65,414 had been prescribed melatonin at least once and reportedly took it for at least a year. The second group of individuals had also been diagnosed with insomnia, but were never prescribed melatonin.
Members of each group were then matched up based on 40 factors, including demographics such as age, race and ethnicity, and sex, as well as concurrent health conditions and other medications. The researchers excluded individuals with prior heart failure diagnoses and those who were prescribed other sleep aids.
The study’s limitations
The study had several limitations. For instance, a prescription for melatonin is only required in certain countries, and geographical information is not included in the TriNetX data sets. Similarly, the researchers could only account for melatonin documented in a person’s medical records, meaning anyone taking the supplement over the counter would have gone unnoticed.
Other limitations included the way hospitals code heart failure in their systems, and vague information about the severity of a participant’s insomnia or any other mental health issues they suffered from.
“Worse insomnia, depression/anxiety or the use of other sleep-enhancing medicines might be linked to both melatonin use and heart risk,” Nnadi said. “Also, while the association we found raises safety concerns about the widely used supplement, our study cannot prove a direct cause-and-effect relationship. This means more research is needed to test melatonin’s safety for the heart.”
Dr. Nancy Collop, director of Emory University’s sleep center, told Straight Arrow News that while she hadn’t heard of a risk for heart failure among habitual melatonin users, the findings are “interesting” and should be studied further.
“I believe there have been some concerns in the past about BP (blood pressure) elevation with melatonin, but that was mostly debunked,” Collop said. “What stands out is that while this is an ‘imperfect’ study due to its nature (use of medical records, retrospective, could have used melatonin without it being documented, etc.), there is a pretty interesting signal there that surely deserves more research.”
How widespread is melatonin use?
Melatonin is a naturally occurring hormone produced in the brain that helps regulate a person’s sleep cycle, also known as their circadian rhythm. While our bodies generate melatonin in the evening, helping lull us to sleep, some people intensify that process by taking a synthetic version of the hormone produced in a lab.
In fact, according to an analysis conducted in 2022 by Sleep Foundation, melatonin use among U.S. adults increased fivefold between 2000 and 2018. Additionally, the organization’s survey of 1,250 American adults found that on average, those who take melatonin do so more than 200 days out of the year, or roughly four times a week. Meanwhile, 38.6% of adults reported taking the supplement daily.
“I’m surprised that physicians would prescribe melatonin for insomnia and have patients use it for more than 365 days, since melatonin, at least in the U.S., is not indicated for the treatment of insomnia,” Dr. Marie-Pierre St-Onge, a sleep researcher who was not involved in the study, said in a press release. “In the U.S., melatonin can be taken as an over-the-counter supplement and people should be aware that it should not be taken chronically without a proper indication.”
Collop told SAN that she only prescribes melatonin as a long-term solution for patients who have a clinically diagnosed circadian rhythm disorder or REM sleep disorder. Instead, Collop prefers cognitive behavioral therapy as the best treatment for chronic insomnia, and said that there could be “other potential causes” and non-medication treatments for insomnia.
“I think the most important thing is to not jump to conclusions about this abstract, as it is not peer reviewed and there are some limitations,” Collop said of the study. “However, it is probably best to avoid taking melatonin on a regular basis without discussing it with your health care provider.”
The post The big sleep: Melatonin could lead to higher risk of heart failure appeared first on Straight Arrow News.
Ella Rae Greene, Editor In Chief
